Thanks to a federal law that aims to make health care costs more transparent, patients can now search hospital websites for an inkling of what various procedures might cost them.

But the information will be of limited use to people with insurance coverage. Their actual costs can vary based on the type of insurance they have and their individual circumstance, hospital officials say.

“This data does not reflect what a patient’s insurance actually pays or what their costs will likely be based on their individual benefits,” said Jenni Alvey, senior vice president and chief financial officer of IU Health in a written statement. “To further help patients, the Medicare requirements should involve health insurance companies so that they also have a role in price transparency efforts for consumers.”

What the new price transparency law actually does

Although the 2010 Affordable Care Act required that hospitals make public their standard charges, it did not stipulate a format for doing so. In April of 2018 the Centers for Medicare and Medicaid Services updated its guidelines to specify that hospitals should post such information online. The disclosure requirement began Jan. 1.

For now, the standard-charges lists reflect hospitals’ chargemaster lists, which exhaustively detail every item for which a health facility can bill, from a specific procedure that can run thousands of dollars to common pills that may add less than a dollar to a patient’s tab.

Hoosiers already have a price comparison option

Unlike the chargemaster item-by-item lists, this website calculates the overall cost of a procedure, which may include several different itemized charges. MycareInsight.org allows users to compare hospitals across cost and quality and will likely provide better insight into the final hospital bill, said Brian Tabor, president of the Indiana Hospital Association.

Indiana has a tool for comparing hospital prices called mycareINsight.(Photo: Screenshot)

“One really couldn’t go to the full list of standard charges and build out a procedure,” Tabor said. “You would have to know every single component that would be involved with a procedure to figure out what that total might be, and that would be a near impossible task.”

By the end of this month MycareInsight.org will include information for the 100 most common inpatient and 75 most common outpatient procedures. Last month about 1,300 people used the website.

But it, too, only provides part of the story. It does not take a person’s insurance coverage into account, Tabor said.

And although local hospitals have complied with the law that they post their chargemaster lists, finding the information is not always that simple.

With more than 100,000 billing codes, the lists can be dizzying. Complicating matters, different hospitals present the information in different ways on their site.

How to find prices on Indianapolis hospital websites

To find charges for St. Vincent, one must scroll to the bottom of the home page and click on the section marked “Hospital Pricing.” Then, the visitor clicks on the location in which the services will be provided and a number of disclaimers pop up, including the following:

"A hospital visit or encounter might include multiple services or items from this list and might vary from patient to patient for the same service depending on any complications or different treatment provided due to the patient’s health status.”

Visitors next are encouraged to choose a hospital and department after which they can see a list of procedures and costs.

On the IU Health site, visitors to the home page must know to click on “Pay a bill.” Then they need to click on Frequently Asked Questions and scroll about two-thirds down the page to “What Should I Expect to Pay.” The answer contains a link to the chargemaster list.

Franciscan Health has visitors to its home page navigate to "Billing and Insurance" and then to "Price Quotes and Standard Charges." Visitors can then link to an Excel sheet for each of the 12 Indiana Franciscan facilities, as well as its Illinois site.

Community Health Network has a tab about two thirds of the way down on its "Central Pricing" page on which visitors can click to see an Excel sheet of charges. Before linking to the page, visitors must agree to a four-part disclaimer. The disclaimer states that the fees include hospital charges only and not that of doctor’s fees; that multiple charge items may factor into the cost of a service; and that the contents of the lists are not intended for media use.

In addition, the disclaimers say that patients can receive individualized estimates of their costs from Community Health’s Central Pricing office.

Most of the local hospitals offer such individualized cost estimates, noting that these estimates take into account a patient’s individual circumstances including insurance coverage. Patients appear to be taking advantage of the opportunity; in 2018 IU Health made about 35,000 such estimates, Alvey said.

For now, such individualized assessments in most cases will be far more useful for patients than checking out the newly posted hospital chargemaster lists, Tabor said.

“In general transparency is a good thing, so more information is better. But this is not likely to be really what consumers are looking for,” he said.

Call IndyStar staff reporter Shari Rudavsky at 317-444-6354. Follow her on Facebook and on Twitter: @srudavsky.